Pacific Northwest Homestay Hosting Application

Hosting Application

Thank you for your interest in becoming a Homestay Host.

Please fill all items to assist us in evaluating your potential participation in our program.

Contact Information
Name:
Home Phone:
Day Time Phone:
Fax:
Email:

You and Your Household	You	Person 2	Person 3	Person 4
Name:
Gender:	Male Female	Male Female	Male Female	M F
Age:
Relationship to you:
Occupation:
Interests and Hobbies
Languages spoken
Smoker?	Yes No	Yes No	Yes No	Yes No

Your Dwelling and Neighborhood
Address; Neighborhood:
Between cross streets of:	and
Closest bus line(s); and which stop(s).
How many blocks to that stop?	1 2 3 4 5 6 7 More
What kind of dwelling do you live in?
Do you have a yard?	Yes No
How many bedrooms are available for guests?	1 2 3 More

Bedrooms	Bedroom 1	Bedroom 2	Bedroom 3
Size of beds:
How many flights of stairs from main entrance?	1 2 3 More	1 2 3 More	1 2 3 More
Check all available items:	TV Phone Fridge AC Desk Private Bath Shared Bath	TV Phone Fridge AC Desk Private Bath Shared Bath	TV Phone Fridge AC Desk Private Bath Shared Bath

Lifestyle
Would you permit guests to smoke inside your home?	Yes No
Would you permit guests to smoke outside your home?	Yes No
Do you have any pets?	Yes No	How many and what kinds:
What time do you leave during the day.
What time do you return?
Are you comfortable leaving guests alone in your home?	Yes No
Do you have time in the morning to prepare a continental breakfast for your guests?	Yes No
Are you comfortable giving guests a set of keys to your home?	Yes No

Is there a time you prefer your guests:
Use a shared shower or bath?	Yes No	What Time?
Finish their breakfast:	Yes No	What Time?
Leave in the morning:	Yes No	What Time?
Return in the evening:	Yes No	What Time?
Finish their dinner:	Yes No	What Time?
Do you observe any dietary restrictions?	Yes No	Please describe:
Do you have 30-60 minutes a day to spend with guests?	Yes No	What Time?
Would you accept guests with teenage children?	Yes No
Would you accept guests with younger children?	Yes No
Would you accept guests with babies?	Yes No
What kind of guests would you prefer?
Please tell us more about your household and lifestyle.

Is there anything else that you would like to add?
Is there anything else that you would like to ask?

If you have any problems submitting this form, please e-mail us instead, providing the same requested information.

Contact Information

Telephone: 206-533-0401

FAX: 206-533-1368

Postal address: Pacific Northwest Homestay
18846 Midvale Avenue North
Shoreline, WA 98133 USA

Electronic communication: General Information and Inquiry: [email protected]
Customer Support: Aieleen Lanot
Reservations: Guest Application

Send mail to [email protected] with questions or comments about this web site.
Copyright � 2001 Pacific Northwest Homestay
Last modified: September 17, 2001